Volume 17 · Issue 4 · July/August 2007 | Download PDF
by Scott McNutt
Recent news stories have highlighted how the U.S. military is providing its personnel with limb loss with state-of-the-art prostheses and is working to return those who want to do so to active duty.
Such staunch assistance is in direct contrast to the hit-and-miss approach taken with firefighters, police officers, emergency medical technicians (EMTs) and other public safety personnel with limb loss in jurisdictions across America. Some return to duty with the support and assistance of their supervisors. Some are forced to fight their way back to duty in the courts. And some never again get the opportunity to do the jobs they love.
Los Angeles Fire Captain Greg Malais
National Standards, Local Interpretations
David Dunville, national director of the Amputee Firefighters Association (AFFA), says there are two issues that arise when firefighters, police officers and EMTs with amputations try to return to duty. One is the interpretation of National Fire Protection Association (NFPA) standards.
“Most states go under the NFPA,” says Dunville. “One part of the standards state that, to become a firefighter, your ankles have to be able to move or the wrist has to be able to move. And that right there means that anyone using a prosthesis, which doesn’t have an ankle or a wrist, can’t pass.”
However, requalifying personnel who lose limbs after passing the initial test is left to local jurisdictions. In some cases, possibly where concern has been expressed over the liability involved in returning firefighters with limb loss to active duty, NFPA standards may be strictly adhered to. “The interpretation of those standards is the problem,” says Dunville. “They interpret, they read into it, and they read around it.”
For 18 years, Wayne Mosley was a firefighter in Oklahoma for the Yukon Fire Department. In 2005, a motorcycle accident cost him his left leg above the knee. He says that local authorities ping-ponged his case between them, until he was finally forced into early retirement. “The pension board pushed it to the point where they said it was up to the city, the city would say, ‘No, it’s up to the pension board.’ ‘No, it’s back up to the city.’ And they fought that decision back and forth. Liability. That’s all it was.”
Mosley hopes a new, uniform standard is established under which he could return to duty, even if only in an administrative role. If he returned to duty, “I hope it would set a precedent for other public safety personnel with limb loss in Oklahoma,” he says.
Dunville himself is another example. He was a firefighter for nearly four years until an accident in the fire station led to the amputation of his lower left leg in 2003. He has not returned to active duty. “I’m still trying to get back,” he says. “Unfortunately, it always seemed that whenever I got the door open, it got shut because, ‘Now we have this question…’ They just like to find new hoops for me to jump through.”
Dunville says that departments supportive of returning personnel may not strictly follow the NFPA standards or will interpret them favorably, because they see that the standards don’t adequately take into account the functionality of modern prostheses. In some cases, public safety personnel have only had to pass the same written, physical and agility tests they took when they joined.
Pamela Lafoe, of the Citrus County Sheriff’s Department, was in a motorcycle accident in 2006 with her friend Kathleen “Kitty” Dolan, who works for Pasco County Fire Rescue. As a result of the accident, Lafoe had a hemipelvectomy on her left side. Dolan’s left leg was amputated below the knee.
“I was back less than two months later to the job that I was doing, which is the training officer,” explains Dolan. “I have to go through an agility test. There’s no problem with that. Everybody in the department has to go through the same agility test. I can crawl around on my hands and knees in a blackened space and I can still drag a section of hose. I can carry a hose. I can climb a ladder. I have no problem if they put me front line, because that’s what I want.”
“My sheriff is wonderful,” says Lafoe. “They’ve bent over backwards for me. They even came to my house and set up a computer for me to work from because I can’t go back on the road. I wouldn’t have to pass the test, but I couldn’t do it if I had to.”
David Dunville with Karen Scruggs and Kim Duckett, CP
David Dunville (L) with Karen Scruggs,
a below-knee amputee who works for the
Georgia Highway Emergency Response
team, and Kim Duckett, CP.
A Lack of Knowledge
A lack of knowledge of prosthetic capabilities is another issue. “The NFPA does not review prosthetics,” Dunville says. “So they have no clue. If the NFPA board were actually to appear at an Amputee Coalition national conference, I think they would wake up and go, ‘Wow, we’re stupid.’ I hate to put it that way, but that’s what it comes down to. They aren’t educated enough in prosthetics.”
Greg Malais is a Los Angeles City fire captain who lost his lower right leg when a fire truck rolled over it in 2002. He was determined to return to duty after his rehab, so, on his own, he took and passed the entry-level test replicating firefighting situations. A friend videotaped it as proof of his capabilities. But the department refused to take his desire seriously, even after a doctor declared him fit for duty a year after his accident.
“It ended up being a legal battle,” says Malais. “I went through the worker comp system. All they look at is, is he back up to pre-injury status, and stuff like that. I won on every level.”
After a trial judge slapped the city with the maximum fine for discrimination allowed in a workers’ comp case, the city’s head attorney agreed to allow Malais back on active duty. Malais says the fire chief refused to authorize it.
“There was no single argument against me,” says Malais. “He would just come up with these excuses. NFPA was his first one. Then, ‘What if Greg’s leg fell off in a fire?’ ‘Could Greg pull up a guy who fell through a roof?’ He was just looking for every negative thing.” But in June 2006, Malais returned to active duty at the same station and on the same shift he was on when he got hurt. He has fought several fires in the time he has been back.
Morgan Sheets, national advocacy director for Amputee Coalition’s Action Plan for People with Limb Loss (APPLL), says a federal standard would be a step in the right direction. She notes that Amputee Coalition works to help people with limb loss return to work by networking with people who could help in an amputee’s community. “We’re working with public safety personnel with limb loss who are forced into disability retirement or are otherwise blocked from returning to work,” says Sheets.
The varying standards for public safety personnel from jurisdiction to jurisdiction appear to be a major stumbling block for personnel with limb loss getting treatment equal to that of military personnel with limb loss.
David Dunville expresses mixed feelings about this dilemma. “God bless the federal government for providing military personnel the equipment to return to active duty,” he says. “But when military personnel are encouraged to return to duty, and contract or federal firefighters who are amputees have insurance that won’t pay for the right type of prosthesis or are being turned down for promotions, then the government is sending mixed messages. They have set up a very confusing situation. And that needs to be fixed at the national level.”
Through the AFFA, Dunville is advocating for a federal standard that would apply across the board, developed through input from lawmakers, public safety personnel and makers of prosthetic components. “What would be the ideal for me,” says Dunville, “would be to bring the fire chiefs’ association, the police chiefs’ association, all the associations to a large facility and have a conference at the same time as the Amputee Coalition conference. They would see that it doesn’t matter whether you have an upper-extremity or lower-extremity amputation – people can do it.”
Adds Lafoe, “We might have to do it differently, but we’ll get it done.”
About the AFFA
The Amputee Firefighters Association is open to all firefighters, law enforcement and EMT/ paramedic personnel. For more information, go to http://www.freewebs.com/amputeefirefightersassociation
Note: No funding from the Centers for Disease Control & Prevention (CDC) is used to support Amputee Coalition advocacy efforts. The views represented in this article do not necessarily represent the views of the CDC.